CareFirst Careers

Regulation Mandates Consultant

Resp & Qualifications

This position directly supports a variety of strategic and knowledge services for CareFirst Mandates and the SPMOS Division overall.   This senior-level individual contributor role will provide a combination of skills to advance and mature Mandates organization, covering a broad range of areas including: BCBSA portfolio knowledge, internal and external liaison functions, workflow, customer service, communications, training, strategic delivery, efficiency, cost reduction and skill development initiatives.   Skills required for this position include strong business acumen, analysis, collaboration and problem solving skills.   The incumbent must be able to make things happen, drive solutions and resolve issues through strong relationships, technical and business knowledge, as well as strategic thinking.  

This role also provides strategic and tactical planning and consultation to Mandates and Business Senior Management as it relates to the implementation of key projects, organizational change, communication and operational improvements.  It requires extensive knowledge and experience related to CareFirst business, extensive knowledge related to one or more of the following functions is necessary: BCBSA, governmental mandates, business and systems IT processes and/or standard health plan functions.

Excellent communication skills are required to establish strong working relationships both internal and external to the Mandates department, persuade, gain initiative and cooperation, and provide formal presentations to various sized groups and levels within the company, to reach consensus, establish and attain goals and resolve conflict.  Excellent written skills are required to prepare reports/documents for internal presentations as well as presentation to various Executive meetings, the CEO and/or the Board of Directors or outside areas, such as BCBSA and other organizations or vendors.

ESSENTIAL DUTIES AND RESPONSIBILITIES include, but are not limited to, the following:
Duties and Responsibilities

Strategic Regulatory Project Leadership: 
•   Primary/dedicated Regulatory point of contact for  Corporate Initiatives (CI) and Day-to-day (DTD) projects.
•   Identify and own remediation effort of corporately identified issues.
•   Take a lead role in various department and divisional projects, to ensure compliance with project compliance requirements, providing input on work team participants, identification of business needs and development of solutions, training, collaboration and communication. 
•   Identify opportunities to create more robust processes surrounding new mandate projects to improve the throughput of the department, streamline operations, improve project outcomes and increase strategic alignment of technical delivery with business operations.
•   Leverage strong business acumen to act as a subject matter expert on a variety of cross departmental projects, adding strategic perspective to project and problem solving efforts.  

Organizational Communication Management
•   Present content, insights and guidance to other Mandates and other CareFirst business areas, BCBSA and/or Blues Plans as needed for generating successful knowledge sharing and working relationships. 
•   Collaborate with other CareFirst SBU’s and functional areas to help with identification of CI workflow opportunities driven by projects, operational changes and/or external regulations.  
•   Develop materials to educate the Mandates area on CareFirst operations on a global level, drive information sharing, conduct planning and workshop sessions to elicit information, identify impacts and drive change. 
•   Optimize the level of knowledge the Mandates staff has for CareFirst SBU’s processes/functions to create better working relationships and robust requirements documentation for CI’s.
•   Represent CareFirst Mandates in various industry Summits, Forums and conferences and company-wide CI’s or projects that have global impacts.

Divisional Communications, Training and Planning
•   Train Mandates staff on internal CareFirst systems/platforms/processes
•   Conduct internal department knowledge transfer and trainings on Internal business processes,  BCBSA processes, BlueWeb and other mandate functions as needed.
•   Collaboration, mentoring and guidance of the Mandates team to complete key CI & DTD project documents, with high quality in accordance with department expectations. 
•   Evaluate training materials, determine opportunities for improvements, and work with the training staff to refine / improve content. 
•   Support the efforts of the Mandates team in the creation, quality assurance and refinement of CI Project descriptions and divisional plan milestones.  Provide insights on proper wording to make technical projects understandable to an executive audience. 

Design, Develop and Review Operations, DTD and CI Documentation: 
•   Support internal and external policy decisions by providing sr. management with extensive analysis and recommendations on the operational impacts to CareFirst from external mandates.
•   Identify potential areas for new or expanded processes, organizational interactions and documentation to put Mandates in a better position for project success.
•   Optimize existing processes, improve workflow and increase efficiency of the Mandates department 
•   Design process improvements, facilitate and coordinate assessments with company leaders to promote CareFirst.



•   Bachelor’s Degree in a Business, Finance or Technology fields. 
•   8+ years in combination of  Business, Strategy/Planning, Regulatory, Information Technology, Project Management experience in healthcare environments.
•   Proficient in MS Office suite: MS Project, Excel, PowerPoint.

•   Advance degree or Certificate in Business, Finance or IT fields; or equivalent experience. 
•   Experience and exposure to both IT and Business functions in a management position.
•   Strong experience in connecting strategic imperatives to tactical project delivery, in collaboration with senior business and IT executives. 

Other Abilities/Skills:
•   Ability to think strategically, to align underlying project work to the strategic objectives they support, and to clearly see cross-functional project impacts to overall strategy. 
•   Capability to evaluate principles, methods, and tools to organize work, set priorities, and determine resource requirements; determine short- or long-term goals and strategies to achieve them; coordinate with other organizations or parts of the organization to achieve results and improve performance. 
•   Experience in business process reengineering methods, metrics, tools, and techniques.
•   Ability to effectively adapt to rapidly changing technology and apply it to business needs, developing approaches to more effectively align technology to business strategy attainment. 
•   Ability to work with clients and customers with courtesy and tact to assess their needs, provide information or assistance, resolve their problems, or satisfy their expectations.
•   Ability to make sound, well-informed, and objective decisions; perceive the impact and implications of decisions; commit to action, even in uncertain situations, to accomplish organizational goals; cause change.
•   Ability to communicate effectively, both orally and in writing; expresses/conveys information (for example, ideas or facts) to individuals or groups effectively, taking into account the audience and nature of the information (for example, technical, sensitive, controversial); and make clear and convincing oral presentations.
•   Ability to inspire, motivate and guide others toward goal accomplishments. Encourage and facilitate cooperation within the organization and with customer groups; foster commitment, team spirit, pride, trust. 
•   Strong strategic thinking and planning skills. 
•   Excellent analysis, problem-solving and negotiation skills.

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer.  It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Hire Range Disclaimer

Actual salary will be based on relevant job experience and work history.

Where To Apply

Please visit our website to apply:

Closing Date

Please apply before: 12/12/2020

Federal Disc/Physical Demand

Note:  The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.


The associate is primarily seated while performing the duties of the position.  Occasional walking or standing is required.  The hands are regularly used to write, type, key and handle or feel small controls and objects.  The associate must frequently talk and hear.  Weights up to 25 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship

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